Liang Shengyuan, Jia Zhiqiang, Emir Rezia, Chen Xinyue, Peng Yishuai, Tian Xuwei, Ma Ailing
School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, China.
First People's Hospital of Kashgar, Kashgar, China.
Sci Rep. 2025 Jul 25;15(1):27166. doi: 10.1038/s41598-025-12659-3.
Early breast cancer detection rates are low in Kashgar, Xinjiang, China, potentially due to poor spatial accessibility to diagnostic services. This study examined the association between travel burden from patient residences to hospitals and the stage of breast cancer at diagnosis in this population. We analyzed data from 981 female patients (aged > 20 years) diagnosed with breast cancer at the First People's Hospital of Kashgar between 2019 and 2022. Driving distances were calculated using the Baidu Maps API. Multivariable multinomial and binary logistic regression models were used. 29.9% of the sample were diagnosed at an advanced stage of disease. Residing more than 20 km from secondary hospitals increased the relative risk of advanced-stage diagnosis by 1.61-fold (95% CI: 1.20-2.31, vs. early-stage) and the odds by 1.48 times (95% CI: 1.07-2.05, vs. non-advanced stage). Similarly, living more than 80 km from tertiary hospitals was associated with an elevated relative risk (RRR = 1.38; 95% CI: 1.08-1.75, vs. early-stage) and 1.40 times the odds (95% CI: 1.04-1.90, vs. non-advanced stage) of advanced-stage diagnosis. Longer travel distances to both secondary and tertiary hospitals are associated with increased risks of advanced-stage breast cancer at diagnosis in Kashgar. Enhancing spatial accessibility to diagnostic services is crucial for improving early detection and potentially downstaging breast cancer in this and similar remote regions.
中国新疆喀什地区早期乳腺癌的检出率较低,这可能是由于诊断服务的空间可及性较差。本研究调查了该人群中患者住所到医院的就诊负担与乳腺癌诊断分期之间的关联。我们分析了2019年至2022年间在喀什地区第一人民医院确诊为乳腺癌的981名女性患者(年龄>20岁)的数据。使用百度地图应用程序编程接口计算驾车距离。采用多变量多项和二元逻辑回归模型。29.9%的样本被诊断为疾病晚期。居住在距离二级医院20公里以外的地方会使晚期诊断的相对风险增加1.61倍(95%置信区间:1.20-2.31,与早期相比),优势比增加1.48倍(95%置信区间:1.07-2.05,与非晚期相比)。同样,居住在距离三级医院80公里以外的地方与晚期诊断的相对风险升高相关(相对风险比=1.38;95%置信区间:1.08-1.75,与早期相比),优势比为1.40倍(95%置信区间:1.04-1.90,与非晚期相比)。在喀什,前往二级和三级医院的就诊距离越长,与乳腺癌诊断时处于晚期的风险增加相关。加强诊断服务的空间可及性对于改善该地区及类似偏远地区的早期检测以及可能降低乳腺癌分期至关重要。